Provider Demographics
NPI:1144473661
Name:LOTT, NOAH THOMAS (MD)
Entity type:Individual
Prefix:DR
First Name:NOAH
Middle Name:THOMAS
Last Name:LOTT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3909 MCFARLAND BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTHPORT
Mailing Address - State:AL
Mailing Address - Zip Code:35476-2838
Mailing Address - Country:US
Mailing Address - Phone:205-333-1993
Mailing Address - Fax:205-333-0782
Practice Address - Street 1:3909 MCFARLAND BLVD
Practice Address - Street 2:
Practice Address - City:NORTHPORT
Practice Address - State:AL
Practice Address - Zip Code:35476-2838
Practice Address - Country:US
Practice Address - Phone:205-333-1993
Practice Address - Fax:205-333-0782
Is Sole Proprietor?:No
Enumeration Date:2008-10-28
Last Update Date:2012-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALL.3089R207Q00000X
TXN9733207Q00000X
ALMD.30177207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1821185299OtherNPI CORPORATE
TX21721320Medicaid
TX1821185299OtherNPI CORPORATE